Week of 5/11/2020

/Week of 5/11/2020
Week of 5/11/2020 2020-05-26T04:17:42+00:00

May 13, 2020

COVID-19 Updates

You are getting tired of COVID-19. We are getting tired of COVID-19. Reopening attempts have begun. They look different in different places. Trade-offs between different paths forward are rabidly discussed. It is hard not to feel anxious. Yet, we will get through this as a society and we feel it is our role to provide you the highest level of primary medical care possible to achieve your health ambitions. We loved telemedicine before COVID-19. We also believe that your physical visits to our clinic are of lower contagion risk than are your visits to grocery stores, which themselves are low risk if done smartly. We are here. We are open. You are our patient family.

Preventive Care Remains Crucial For Health

Health metrics for the past 2 months are now showing that primary care visit numbers are way down, ER visits are way down, and more troubling, people are dying at home from things like heart attacks that potentially could have been prevented. We have heard from some of you that you haven’t wanted to ‘bother’ us while there are people with coronavirus to take care of. While we sincerely appreciate that you are thinking both of others and of us (really, we are touched!), we are HERE for YOU, and we want you to know that we continue to have ample availability to see you for all of your health needs, whether urgent, chronic, or preventive.

Our telemedicine, phone, and text-based care options mean that for much of your care, you can get the attention and solutions you need without leaving your home. Should you need to come in (there still are things that an in-person exam can’t replace), rest assured that we continue to take evidence-based steps to ensure your safety when you visit our clinic. This includes having all of us wear a mask when seeing you, asking you to come masked (and wear it while you are in our office), and cleaning and disinfecting our hands and our clinic surfaces, like always.

Please reach out if you are putting off care – we can and would very much like to see you or talk to you!

Bodying the Antibody Test

Here is a helpful diagram that reminds us how different testing for COVID-19 infection plays out along the timeline of a typical COVID-19 infection. The solid blue line represents the nose/throat swab we can obtain from you for PCR testing for active infection. The dotted green line represents the blood sample we can obtain from you for IgG antibody testing (performed by UW Virology, accuracy update below) for immune response to infection.

Recall how uptight we are about communicating testing accuracy to you.  UW Researchers authored a May 7 online publication in the Journal of Clinical Microbiology (ref: https://jcm.asm.org/content/early/2020/05/07/JCM.00941-20) describing their validation study of the Abbott SARS-CoV-2 IgG antibody test, and Dr. Warren recently had a follow-up phone conversation with the senior author on the paper, Alex Greninger, Asst Director of Clinical Virology at UW. The bottom line is that this particular antibody test continues to prove exceptionally accurate with low potential for both false-positive and false-negative results, in contrast to the vast majority of other tests on the market that are so plagued by unacceptable false-positive potentials they should be taken off the market.

Low potential for false-positives: UW Virology used the antibody test upon 1,020 serum specimens they had collected in 2018 and 2019 prior to SARS-CoV-2 circulation in the U.S. and found only one false positive, indicating a test specificity of 99.9%, even higher than the 99.5% reported by Abbott in the package insert. With that specificity, were there a 5% prevalence of ‘recovered’ COVID-19 in the group being tested, for every 50 true-positives (you people really were infected) there would be only 1 additional false-positive (test says you were infected but you really were not).

Low potential for false-negatives: UW Virology tested 689 serum specimens of 125 hospitalized patients who had tested positive for infection by PCR. By day 17 after symptom onset and day 13 after PCR positivity, the sensitivity reached 100% (ie zero missed infections). Therefore, for those of you who have sought the antibody test through Wise Patient because you wonder if ‘that severe illness’ you had earlier in the year was actually COVID-19, if your antibody test returns negative (ie no antibody detected) you have every reason to trust that you did NOT have COVID-19. Disappointing, huh! That said, we don’t yet know the false-negative potential for this antibody test among people infected with COVID-19 (PCR+ for SARS-CoV-2) but without symptoms or with minimal symptoms. Those data will hopefully come.

As always, we remind you that there is no evidence yet that being IgG antibody positive is protective against reinfection.

Welcome Arani!

My name is Arani and I am new to Wise Patient as of a few weeks ago! Prior to coming to Wise Patient, I worked at an urgent care as a Registered Medical Assistant and am looking forward to growing my skills and learning more about primary care. I’ve grown up here in the Seattle area and graduated from the University of Washington (Go Dawgs!) with a Biology degree in 2018. When I’m not at work, I enjoy working out, spending time outdoors (while practicing social distancing of course), reading a good book, and watching shows on Netflix. It’s been great working here so far and meeting a few of you so far and I look forward to hopefully meeting each of you in the near future!

Reliable Sources to Stay Updated on the COVID-19 Outbreak

If you have any questions, please contact our office at: info@wisepatientim.com